The Connection Cure: The Prescriptive Power of Movement, Nature, Art, Service, and Belonging

The Connection Cure: The Prescriptive Power of Movement, Nature, Art, Service, and Belonging by Julia Hotz, Simon & Schuster

As I’ve been working on this review, I’ve been plagued by bouts of sleeplessness for reasons I can’t explain. It was only a few weeks ago that I could easily fall asleep and then wake up blissfully refreshed after an uninterrupted eight hours of rest. Now, I find myself trapped in an ongoing, bleary-eyed cycle of drinking coffee to try and wake up and ending the night with tea and melatonin to try and sleep, barely succeeding on either front. But worse than the physical effects of my sudden insomnia are the emotional and mental ones. I’ve been frustrated that I can’t pinpoint the root of the issue and anxious that there’s some terrible underlying issue waiting to be discovered. I’m restless, irritable, and feeling hopelessly stuck.

When we feel unwell, writes journalist Julia Hotz, many of us default to a common course of action:

We get sick and go to a doctor, who gives us a diagnosis. We get treatment, usually a prescription for a pill. We do it again the next time we don’t feel well. Diagnose. Treat. Repeat.

Yet something isn't working. Despite relatively easy access to medicine and treatments that our ancestors could have only dreamed about, we continue to see an increase in lifestyle ailments such as diabetes and hypertension; in mental ailments such as ADHD, depression, and addiction; and most insidiously, in isolation and loneliness. Hospital wait times are getting longer and medical costs are skyrocketing as we search for solutions, and still, somehow, as a society, we can’t seem to escape these chronic conditions. What are we missing?

Hotz asserts that, while there are legitimate biomedical issues at hand for which there are pharmaceutical solutions, much of our unwellness is compounded by the stressful, disconnected world we live in. The solution for complete wellness, then, comes from creating a better environment for ourselves, one in which we are meaningfully connected to the rest of humanity. The way to get there is via social prescribing. “A social prescription,” she writes, “is officially defined as a nonmedical resource or activity that aims to improve a person’s health and strengthen their community connections.” Working in tandem with the standard medical treatments that address the symptoms of disease, social prescriptions offer a way for individuals to reconnect to the things that make them feel truly alive. Hotz highlights five key categories of social prescriptions: movement, nature, art, service, and belonging. By considering these elements, we shift our perspective of how wellness can be achieved:

In fact, that’s what social prescribing is all about; instead of “what’s the matter with you”—a fixed list of symptoms—it focuses on “what matters to you”—a set of inherently unique interests, needs, and life events.

These social prescriptions have long appeared across history and cultures. As Hotz notes, before the advent of modern medicine and comforts, our earliest ancestors were highly physically active in their daily work of surviving predators, gathering food, and building shelter. Yet they also processed their stress through the creation of art and fostered community with their neighbors to ease the burden of survival. “Movement, nature, art, service, and belonging were once staples of our daily lives,” Hotz writes. “But since our survival no longer requires these five ingredients, we no longer structure our lives around them.” We have an easier, more comfortable existence than our predecessors, but our ability to fend for ourselves has also made us all lonelier. We’ve equated optimal health with the fulfillment of our basic needs for survival, yet we have generations’ worth of proof that good health is far more expansive and interconnected.

In the first section of the book, Hotz highlights each of the five social prescriptions with stories of individuals whose lives dramatically improved after incorporating at least one of these ingredients into their lives. Their methods all vary—one reconnects with a childhood love of cycling, another finds a balm for their fractured attention span in the simple activity of fishing, others find healing from past traumas through making art or volunteering, and so on. Hotz then examines how social prescribing has been implemented across a variety of locations—large countries, small ones, those with public health services and those with privatized insurance, et cetera—with overwhelming success. Finally, at the end of the book, Hotz decides to test out each of the five prescriptions for herself and documents the positive changes she experiences.

What all these individuals ultimately find through their engagement in movement, nature, art, service, and belonging is a re-establishment to their communities. Hotz writes:

In some ways, the five ancient medicines were just shortcuts to the true source of healing: the medicine that Cormac Russell called a connected community. If we belong to a connected community, maybe we don’t need social prescribing after all. Maybe we really can create our own health.

At the end of the book, Hotz asks her friends to answer the question, “What makes you feel healthy?” The answers they give are all different—riding horses with siblings, creating dance routines with summer camp bunkmates, skiing in the company of “really funny people”—but they hold the same five ingredients of social well-being and point to a singular conclusion: “When they had connections, they felt healthy.” Hotz then turns the question outward:

If I were to ask you this same question, reader, I imagine you’d come up with a similar scene—describing times you’ve cherished these five ingredients, and the joy, meaning, and relationships they tend to bring. 

We are conditioned, Hotz notes, to think of our health primarily when we already feel sick, and I realize that my health has been at the front of my mind over the past few days precisely because it feels like it’s eluding me. So, when did I last truly feel healthy?

There’s a memory I keep coming back to from a recent family vacation to Orange Beach, Alabama. I was crouching in the sand beside my two-year-old nephew, the foamy gulf waves gently lapping at our ankles. I vividly remember the look of wonder on his face as he noticed a bird landing beside us, the way he suddenly took off running after it, and how he shrieked with laughter when he realized I was chasing after him, too. That night, I slept for a solid twelve hours and woke the next day brimming with an energy that felt endless. I had initially attributed it only to the physical activity, but I realize now it was due to much more—it was the result of experiencing extraordinary joy in the company of people I love.

I’ve been frustrated that the diagnose-treat-repeat cycle hasn’t been working for me, that my current insomnia couldn’t be solved simply by throwing more melatonin gummies at it. I’d let myself get stuck in a mental rut, ruminating on my stress and forgetting that, even in this brain fog I’m in, life is still going on around me, waiting to be lived. After reading this book, however, I’ve realized I can do more for myself. Until my sleep pattern restores itself, I'll still be sleepy, whether I’m mindlessly staring at my living room wall or rounding up my friends for an impromptu picnic on the shores of Lake Michigan. Why not take the more joyful route, then? Why not, for that matter, let every future health issue find me up on my feet, making the most of every moment?

“[Health] is usually complicated,” Hotz writes. “People’s lives are, too.” Achieving a fuller sense of wellness takes time and effort. Social prescribing isn’t a quick fix, but it is accessible, and its effects are transformative. Even when we don’t have all the answers to what ails us, we have the agency to build more curative environments and foster the relationships that can revitalize us. In the final pages of the book, Hotz recalls her own vision of health: a memory of being surrounded by friends, their laughter, Hot Taki residue on their fingers, and a hope that this joy will continue for years to come.

It’s a medicine I’d never pictured a white-coat doctor prescribing. But in that moment, in my own dreamy scene, I realize that this is what health feels like. This is what matters.